Prescription pills don’t equal better sleep in the long run for women, study suggests

Many people suffering from insomnia take medication to get a better night’s sleep.

While many sleep aids work over short periods of up to six months, clinical trial data has showed, insomnia can be a chronic problem — and many people end up taking these drugs for longer.

Much less is known about the long-term benefits of these drugs, said the authors of a new study published in the journal BMJ Open.

The study’s research on more than 600 women ages 42 to 52 in the United States found that those who used medication to help their insomnia over a one- to two-year period did not get a better night’s sleep than those who did not take any prescription sleeping pills.

These medications included benzodiazepines, Z-drugs which include zolpidem (Ambien), zaleplon (Sonata) and eszopiclone (Lunestra), as well as other drugs mostly intended for different conditions, such as anxiety and depression.

An estimated 9 million adults in the US have been prescribed drugs to help with falling and staying asleep, according to the study.

The US researchers from institutions including Brigham and Women’s Hospital in Boston, University of Pittsburgh and Harvard University looked at 238 women who started using medication to treat insomnia and 447 women who didn’t take prescription sleep aids.

The participants were taking part in a much larger study called the Study of Women’s Health Across the Nation (SWAN), which focuses on the changes during menopause. At the beginning of the study period, both groups reported similar levels of sleep disturbance: difficulty falling asleep one out of every three nights, waking frequently on two out of three nights, or waking early.

The women filled out a questionnaire annually, ranking their sleep on a 1 to 5 scale, ranging from no difficulty on any night (rating 1) to difficulty on 5 or more nights a week (rating 5).

After two years, there were no “statistically significant” reductions in sleep disturbances among those taking prescription medications compared with those who didn’t, the study said.

“It re-emphasizes what we know already — that we can’t just give people medication and the story is done,” said Dr. Raj Dasgupta, associate professor at the University of Southern California and a spokesperson for the American Academy of Sleep Medicine.

“We have to inform our patients about the precaution of being on long-term medication, and it’s possible that they might not get the benefit,” added Dasgupta, who wasn’t involved in the research.

He said people struggling with insomnia shouldn’t stop taking medication without consulting their doctor. He noted that the study showed that the women taking prescription sleeping pills didn’t report that their insomnia had gotten worse over the study period.

“Insomnia is very difficult to treat because there’s so many factors going into it. I think this is a time not just to look at the insomnia itself but the roots that cause it,” he added, noting that some of the women in the study had preexisting conditions like depression.

The study authors said that half of the women participating in the research were current or former smokers, and 1 in 5 were heavy drinkers, both of which can affect sleep. Plus, the information on sleep medication was collected on an annual basis, and the drugs could have been used intermittently or stopped for certain periods of time.

“Real-world data … provide important opportunities for looking at the way drugs may actually be used in typical practice,” the study said.

“The lack of benefit observed in the current study suggests that when physicians begin prescribing these medicines they should discuss with patients that many patients continue them long-term, and that there is scant evidence demonstrating benefit to using these medicines beyond several months.”

For people who struggle with insomnia, Dasgupta recommended the following steps:

• Make sure your room is dark and on the cooler side.
• Exercise during the day, preferably during the morning.
• Go to bed and wake up at the same time every day, even on weekends.
• The bed should only be used for sleep. If you can’t sleep, you should leave your bed after 20 minutes and do non-stimulating activities in a dull light. Only go back to bed when you feel drowsy.